BootCamp for Betics Blog

Note: BootCamp for Betics is not a medical center. Anything you read on this site should not be considered medical advice, and is for educational purposes only. Always consult with a physician or a diabetes nurse educator before starting or changing insulin doses.

Did you know that all type 1 diabetics and some type 2 diabetics need injectable insulin in order to live?

Put another way, if a diabetic needs insulin in order to live, and the diabetic does not get insulin, the diabetic will die.

Diabetic death from Diabetic Ketoacidosis is a grisly process, during which acid starts running through your bloodstream, searing your vessels and organs while your body shrivels up in dehydration as it tries to push the acid out of your body through your urine and lungs, and, left untreated, the condition shuts down your organs one by one until you are dead. If you're lucky, your brain will be the first thing to swell itself into a coma and you'll be unconscious for the remainder of the organ failures.

In some cases, this grisly diabetic death can take a few days or weeks to complete its process. Or, if you're one of the luckier less-resistant insulin-dependent type 2 diabetics, you may actually get away with staying alive for quite a few years and suffer only some heart disease, stroke, kidney damage/failure, neuropathy, limb amputations and blindness.

(my intent in describing how lack of insulin leads to death is not to cause fear in people with diabetes or their loved ones; rather, my intent is to make clear the reality that injectable insulin is absolutely vital to diabetics who depend on injectable insulin to live)

While I'd love to go off on a political rant about how insulin should be a basic human right for all insulin-dependent diabetics (and why the hell isn't it?), that's not the purpose of this article.

This article is about how to stay alive when you are insulin-dependent and you can't afford your Humalog, Novolog, Apidra, Lantus or Levemir.

There are actually a few reasons why insulin dependent diabetics can't get access to insulin:

1. They don't have a healthcare plan2. Their healthcare plan offers very poor insulin/diabetes supply coverage3. They can't afford a co-pay4. They can't afford to pay out-of-pocket for insulin5. They are in between insurances and need to stay alive until the new insurance starts

You might be wondering what the cash price is for insulin these days. Well, if you want to check for yourself, feel free to visit http://www.goodrx.com and run a search.

Or you can just read on...

The most common (and most effective) types of insulin on the market are Humalog, Novolog, Apidra, Lantus, and Levemir. Most insulin-dependent diabetics need at least 2-3 bottles of insulin per month in order to survive. Some insulin-dependent diabetics need even more. Insulin comes in various forms, such as vials, cartridges and pens, but the per-vial price is by FAR the cheapest, so that's what we're using for our price list below. Here's the cash price per bottle of insulin by type:

Humalog: $254Novolog: $255Apidra: $241Lantus: $283Levemir: $277

Sometimes, if you pay cash in a pharmacy, you can get a coupon for a 2%-7% discount off the cash price. Sometimes.

So, if the average price of a bottle of insulin is $262 and an insulin-dependent diabetic needs at least 2-3 bottles of insulin per month (to be clear, some people need MORE than this!), that's, at a minimum, $524 - $786 per month for insulin just to keep an insulin-dependent diabetic alive.

Then there's all these other pesky supplies insulin-dependent diabetics need, such as needles (to inject the insulin) - $43.95 per month, and that figure assumes you re-use your needles multiple times each (we're actually against reusing needles, because this causes lipohypertrophy, but the reality is, there's only so much one can afford when diabetic and we have to make sacrifices, and lipohypertrophy is definitely better than dying). And there's also glucose test strips (~$143.96 per month for the cheapest brand-name strips) and if you're really really lucky and have an insulin pump and/or a continuous glucose monitor, there's a few extra thousand dollars per month on top of the insulin. Oh, and there are oral meds and non-insulin injectables, too. I don't have time to list the prices of those right now, but I hope you believe that they are also quite expensive.

Insulin-dependent diabetics who have decent health insurance can get away with paying only a fraction of these prices because their health plan covers a good portion of the cost.

But what if you don't have insurance or a health plan? Or, what if your insurance coverage for diabetes is so crappy, you simply can't afford even the co-pays or co-insurance?

Well, there are various websites that offer information about getting insulin and test strips at a reduced price (or even free, for those who qualify). If you haven't tried to get help from these organizations, you should really do that. There are numerous articles available that can help you find such programs.

This is no such article. THIS article is your last resort. So if you haven't tried to find a program that can help you get your insulin at a reduced price (or free), go do that first. When that fails, come back here.

If you're insulin-dependent and you've exhausted all other opportunities only to discover that you're just not going to get your hands on a bottle of Humalog, Novolog, Apidra, Lantus or Levemir anytime in the foreseeable future, then you have another option for your life-saving insulin. It's not free. But it's gobs cheaper than paying out-of-pocket for the good stuff, and it may cause some of you to stay alive just a little bit longer. And that option is to buy the old-school Reli-on brand insulins at Wal-Mart.

A long time ago (pre-1995), Humalog, Novolog, Apidra, Lantus and Levemir didn't exist. In order to stay alive, insulin-dependent diabetics had to make do using other types of insulin: Regular insulin, NPH insulin, and a few others, too.

To be clear, an insulin-dependent diabetic's BEST chance of staying healthy is to take one or two of the five majorly expensive insulins listed above. But, drug companies are STILL making that old-school pre-1995 insulin! An insulin-dependent diabetic can still survive, albeit with increased level of difficulty, using a few of the old-school, pre-1995 insulins. Lilly and Novo-Nordisk still make these old-school insulins, and insulin-dependent diabetics can pay cash for these old-school insulins in most states withOUT a prescription.

These insulins are called Regular insulin and NPH insulin (there's also a less-popular combo called 70/30).

The brand-name versions of these insulins from Lilly and Novo-Nordisk cost about $130 per bottle.

But guess what. Wal-Mart has its own Reli-on brand version of the same old-school insulins, and Wal-Mart's Reli-on insulin is the EXACT SAME as the old-school insulins still made by Novo-Nordisk. Do you know how I know this? I know this because Novo-Nordisk actually makes the Reli-on insulins that are sold at Wal-Mart.

These old-school insulins have a cash price of roughly $26.00 per vial at Wal-Mart stores and these insulins do not, in most states, require a doctor's prescription. If I can't afford one of the five really awesome insulins that most diabetics are taking, it's possible that I can't afford to see a doctor, either. So it is nice news that most states don't require a prescription for Regular and NPH.

So, if I can't afford my Humalog, Novolog, Apidra, Lantus or Levemir, I am still going to have to suck it up and find SOME way to get my hands on some of the Wal-Mart branded insulin. I wouldn't necessarily say that $26 per vial is cheap, but at roughly 10% of the price of the other insulins, purchasing it may become more manageable for some people.

Now, to those who might read this article and think, "Wow, treating the diabetes epidemic would be so much cheaper if people would stop using the expensive insulin and use the cheap insulin instead," well, that is completely wrong and you should stop thinking those thoughts immediately. This old-school cheap insulin will certainly prevent immediate death, but it is unlikely to result in optimal long-term intensive blood sugar management outcomes that the newer types of insulin support. So, it is still in the best interest of all insulin-dependent diabetics (and it's in the best interest of insurance companies and the community at large) to use the newer types of insulin. But. When you're stuck, you're stuck. And sometimes, you're stuck with old-school insulin.

So, if I were completely stuck (and of course, I'm talking only about what I would do in this situation, because I'm not a doctor and can't give YOU medical advice, so please know that everything listed below is just something that I would do as a diabetic individual), I would figure out which type(s) of insulin I needed from Wal-Mart by reading the comparison charts below, and then I would match my current insulin needs to one or more of the specific circumstances listed below, and then follow the instructions, making sure I'm testing my blood sugar a LOT for the first few days/weeks I'm on the new insulin to make sure I stay safe.

​Insulin Comparison Charts:

Humalog/Novolog/Apidravs Reli-on Regular
Starts working in 10-20 minutes Starts working in 30-45 minutes
Peaks at 1.5-2.5 hours Peaks at 2-3.5 hours
Stops working at 4-6 hours Stops working at 5-8 hours
Can be mixed in same syringe with NPH Can be mixed in same syringe with NPH

Lantus/Levemir vs Reli-on NPH
Starts working in 1-2 hours Starts working at 1-3 hours
Peaks slightly at 8-10 hours Peaks significantly at 4-9 hours
Stops working at 18-26 hours Stops working at 14-20 hours
DO NOT MIX in same syringe with anything Can mix with Humalog, Novolog, Apidra, Regular

If I was taking Humalog, Novolog or Apidra, I should buy a bottle of Reli-on Regular ($26) as its replacement. It is NOT the same as what I was taking, but I can use it (carefully) as a substitute.

If I was taking Lantus or Levemir, I should buy a bottle of Reli-on NPH ($26) as its replacement.
It is NOT the same as what I was taking, but I can use it (carefully) as a substitute.

If I was taking Novolog 70/30 (or even Humalog 75/25), I should buy a bottle of Reli-on Novolin 70/30 ($26) as its replacement. It is NOT the same as what I was taking, but I can use it (carefully) as a substitute.

I would also get a Wal-Mart Reli-on Prime meter ($16.24) and 200 strips ($39.96).

And I would buy a box of syringes ($43.95). Probably 50 unit syringes with a regular (not SHORT) needle. Only because short needles don't always work as well.

Two bottles of insulin plus the other stuff would set me back about $133 dollars total. If I didn't have the money, I'd beg someone for it or borrow it. Or maybe I'd sell my iphone or my clothes or something.

Then, I'd read on to understand what the heck to do with all this stuff depending on my circumstance(s):

Circumstance #1: Switching from Long Acting (Lantus or Levemir) to Wal-Mart Reli-on NPH

First, I'd get myself some NPH. Then, I'd try to remember what my TOTAL DAILY LEVEMIR/LANTUS DOSE is. Let's say I was taking 24 units of Levemir/Lantus per day. I could have been taking 12 units in the morning and 12 units in the evening, or I could have taken all 24 units once a day. That part doesn't matter. All I care about right now is the total daily dose of Lantus/Levemir.

The Lantus/Levemir gets replaced with NPH but it has to be split into two doses, 12 hours apart. To figure out my initial total daily NPH dose as a replacement for Levemir/Lantus, here's what I'd do.

Multiply my total daily Lantus/Levemir dose by .85 (yes, there is a decimal point before the 85) which will calculate a SAFE total daily dose of NPH for me. When you multiply something by .85, it's the same as subtracting 15%. So what I'm really doing here is reducing my total daily dose of Levemir/Lantus by 15% to come up with a SAFE total daily dose of NPH.

In my case, I'd multiply 24 units x .85 = 20.4 units

My new INITIAL and safe dose of NPH is 20.4 units per day.

Then, I'd split that total dose in half, taking half in the morning and half in the evening (every 12 hours).

So in my case, I'd take 10.2 units of NPH around 8 in the morning, because that is when I wake up (I'm a late sleeper) and then I'd take 10.2 units of NPH around 8 in the evening (12 hours later). But, since it's impossible to measure 10.2 units in a syringe, I'd reduce the dose to 10 units.

If I was nervous about going low in the middle of the night due to this new dosing, I could, instead of splitting the dose in half, take 2/3 of the total daily dose in the morning (13.5 units in my case) and 1/3 of the total daily dose in the evening (6.75 units, rounded up to 7, in my case).

My blood sugars might run HIGH initially because of the reduction in total daily basal dose, but running a bit HIGH temporarily is safer than having a dangerous LOW. The only way to know how safe I am with my new insulin is to check my blood sugar frequently as I'm getting accustomed to the new insulin. After 2-3 days, I'd start to gradually increase and/or decrease my NPH doses depending on how my blood sugars were behaving throughout the day. Of course, I would dutifully record all blood sugars using a pen and paper so that I could do a better job analyzing how well the insulin is working. It may become the case that I need to take MORE NPH in the evening than in the morning, or vice versa. Only careful experimentation (via increase/decrease of 5-10% for each dose adjustment every 2-3 days) and frequent blood sugar testing would tell me for sure.

***I MIGHT discover that I don't need any short acting insulin at lunchtime, because the NPH peaks so significantly at that time that I MUST eat in order to prevent a low blood sugar.

***I MIGHT discover that I DO need short acting insulin at lunchtime, but that around 3PM, I need an extra snack because the NPH and the short acting insulin are peaking together.

***I MIGHT discover that I need a morning snack to prevent a mid-morning low blood sugar, because maybe the NPH peaks a little sooner in my body than it does in others'.

***I MIGHT discover that my blood sugar goes a bit low during the night when the NPH is peaking, so I should probably have a bedtime snack that contains carbs and either some protein or fat to help prevent a nighttime low.

***IN FACT, I might just start eating a morning, afternoon and evening snack every day just to be on the safe side.

Circumstance #2: Switching from Rapid Acting (Humalog, Novolog or Apidra) to Reli-on Regular
As I learned by reading the insulin comparison charts above, Regular insulin takes longer to start working in my body than the newer rapid acting insulins. Also, Regular insulin hangs out in my body longer than the newer rapid acting insulins. But fortunately, the amount of Regular I'll need is pretty similar to the amount of newer, rapid acting insulin I used to take.

I use rapid acting insulin (Humalog, Novolog or Apidra) for two reasons. One reason is to take a MEAL BOLUS. In other words, if I eat carbs, then I need to take some amount of insulin for those carbs. I might have a carb ratio, or I might be using a sliding scale. Whatever the method, I (as do most diabetics on mealtime insulin) have some way to figure out how much insulin to take for each meal. Another reason I take rapid acting insulin is to take a CORRECTION BOLUS (extra insulin that I take when my blood sugar is too high).

If I switch to Regular from Humalog, Novolog or Apidra, I can use Regular for MEAL BOLUSES and CORRECTION BOLUSES, but I just need to be extra careful about it, because the way Regular behaves is different from the way Humalog, Novolog and Apidra behave.

The good news about Regular insulin is that I can take the same amount of Regular as I would take of Humalog, Novolog or Apidra for any given meal or correction bolus (except bedtime corrections). BUT. I need to plan this really well.

For a meal bolus, I need to know exactly how much I'm going to eat at least 30 minutes prior to the time I actually eat, and I need to bolus with the Regular insulin 15-30 minutes before I even start eating. Then, I need to make sure I eat exactly what I bolused for.

If I'm going to use Regular insulin to take a correction bolus (when my blood sugar is too high), I need to be extra careful. First, I need to know exactly how long ago my last shot of Regular was. Because if I take a correction bolus for a high blood sugar but there's still a bunch of Regular insulin left in my body (remember, Regular insulin can hang out in your body for up to 7 or 8 hours), then I'm doing something called "stacking insulin," the results of which (read: my blood sugar) could come crashing down hours after I took the shot(s). So before each correction, I would need to ask myself, "Do I really need to correct this blood sugar? Or is there still active insulin in my body right now, just taking its sweet-ass time to work?" I would have to have a lot of patience.

***I MIGHT discover that I cannot safely bolus for high blood sugars without going low many hours later, and that sometimes, I may have to patiently "wait out" my high blood sugar events.

***I MIGHT discover that instead of taking an extra dose of Regular insulin to treat a high blood sugar, I can just wait for my blood sugar to come down as a result of my NPH peaking.

***I MIGHT discover that it's a BAD idea to take a full high blood sugar correction of Regular at bedtime, because if I'm also taking NPH, the combination of those two insulins could result in a nighttime low blood sugar event. Gah!

***I SHOULD really just make sure I have a snack at bedtime if I'm going to be taking new insulin(s), at least until I can figure out how to manage the doses to eliminate the bedtime snack need.

Circumstance #3: Switching from an insulin pump to Reli-on Regular and Reli-on NPH
First, I would figure out what my NPH dose needs to be. In order to do this, I need to look at my pump to figure out my TOTAL DAILY DOSE of BASAL insulin. In my case, the total daily dose of basal insulin is 30 units.

Then, I need to multiple the total daily dose of basal insulin by .85 (there is a decimal point before the 85), which basically "reduces" my "total daily dose of basal insulin" number by fifteen percent.

30 units of total daily basal insulin in the pump x .85 = 25.5 units of NPH per day (initially).

This number (in my example, it's 25.5) is the total daily dose of NPH I'll need, but I'll need to split this dose, taking half of it in the morning, and the other half in the evening, or 12 hours later. So in my case, 15% off my total daily basal dose is 25.5 units. So if I divide 25.5 by 2, that tells me that I need 12.75 units of NPH in the morning, and 12.75 units of NPH in the evening (or 12 hours later). I might round up to 13. Or, if I was nervous about going low at night, I'd move some of that nighttime dose to the morning (maybe take 16 in the morning and 10 at night? I dunno. I'd have to mess around with it in order to figure it out).

At this point, I would definitely pay close attention to Circumstance #1 above to learn more about the features of taking NPH insulin!

Next, I would definitely closely read Circumstance #2 above to figure out how much Regular insulin I need in order to cover meals and high blood sugar corrections (hint: I would use the same carb ratios and ISFs that are in my pump, possibly slightly decreasing any correction boluses at nighttime just to be safe).

Circumstance #4: Staying on the insulin pump (until it stops working) using Reli-on Regular
Yes, I can put regular insulin in my pump. It's not great, but it'll get the job done (kind of). I'll still experience some blood sugar peaks, and it'll take much longer to correct a high blood sugar, but Regular is fine for use with a pump. In fact, pumps were invented before Humalog was invented, so Regular insulin was used in pumps for quite some time (back in the day).

In order to use Regular insulin in my pump, I'll need to set the active insulin time in the pump to 6 or 7 or 8 hours, depending on how long I think the Regular insulin will stay in my body.

Then, I'll need to make sure I bolus for meals 15-30 minutes before I eat them.

Finally, I'll need to try REALLY hard to not rage-bolus when I have a high blood sugar. It's just going to take longer for high blood sugars to come down now that I'm no longer taking that awesome (and expensive) rapid-acting insulin.

Circumstance #5: Switching from Novolog 70/30 to Reli-on Novolin 70/30
This is a unit-for-unit replacement. It's easy. The only thing to remember is that instead of taking my Novolog 70/30 WITH a meal, I now have to take my Novolin 70/30 15 - 30 minutes PRIOR to a meal. Also, I would eat a bedtime snack for the first few nights. At least until I can decide that I'm not in danger of overnight lows while I'm on this insulin. I may discover, after a few days, that it's necessary to slightly increase or decrease my doses depending on how my blood sugar reacts.

Circumstance #6: Starting with Reli-on NPH when I have never been on insulin before
If I've never taken insulin before, it's probably not a good idea to start taking it without checking with a doctor. But as long as I'm over 18 and weight over 100 pounds (which I am and I do), I can probably start taking NPH using a VERY conservative dose, increasing by a small amount every few days until I reach optimal blood sugar outcomes.

NPH Starting dose for type 1s: .4 (yes, there is a decimal point in front of the 4) units per kilogram of body weight per day, 1/3 of which is given at bedtime, and 2/3 of which is given in the morning. Increase gradually until optimal blood sugar results are achieved.

NPH Starting dose for type 2s: .2 (yes, definitely a decimal point in front of the 2) units per kilogram of body weight per day, 1/3 of which is given at bedtime and 2/3 of which is given in the morning.

I would adjust the morning and evening doses every few days in order to achieve optimal blood sugar results.

Of course, I would never start taking insulin for the very first time ever without first consulting with a doctor. Like, ever.

Circumstance #7: Starting with Reli-on Regular and Reli-on NPH when I have never been on insulin before
Seriously, I would go see a doctor before doing this.

Other tricks to reduce my insulin needs (which will, in turn, require me to buy less insulin in all of the above mentioned situations):

1. Exercise more - this helps my cells accept insulin more readily, so I'll need less insulin if I exercise regularly (I would definitely watch out for hypoglycemia events if I started exercising, though)
2. Reduce carbohydrate intake (Reducing my carbohydrate intake to between 100 and 180 carbs can reduce my insulin needs)
3. Take Metformin (requires a doctor's prescription, so I may be SOL here if I don't have access to a doctor). If I could find a way to get my hands on Metformin, that would lower my baseline/basal insulin needs, because Metformin reduces the amount of glucose released by my liver on a daily basis. Metformin was created for type 2 diabetics, but type 1 diabetics can take Metformin, too, and it will reduce a type 1 diabetic's insulin needs (so I would definitely lower my basal insulin dose, and possibly even my bolus doses, if I were going to start Metformin).

Don't want to use facebook for comments? Scroll down to use the old-school comments tool

I appreciated the info. I am on Medicare and after a 3 month supply I am in the donut hole. I have been on a paradigm pump and another one before that for 10 years and now am unable to afford my humalog. I have tried every site to try to get help, but because we have an income that is a little over their limits there is no help. The government should step in. If a diabetic can afford the medications they will not have complications, therefore saving the insurance companies money. I have not been hospitalized for diabetes in over 20 years, because we had good insurance and I am compliant.

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Pam Roberts

3/1/2016 01:43:40 pm

I believe the government has stepped in, and that is why people like you and myself don't qualify.

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I changed from lantus to the walmart insuln. How can anyone afford to pay $400 a month for any meds when there is a less expensive alternative. I even like the walmart insulin better. I feel better and don't have foggy head and haven't gain too much w

12/22/2016 08:23:08 am

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Does your medicare only cover 3 months? I have started buying my Lantus in Mexico and it is half the cost, and works just fine. Might consider a trip south.

1/3/2017 05:31:47 pm

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cheryl hertel

1/27/2017 10:31:15 am

how do you get it from there i am on humalog and it is 500 plus dollars

Sheri

1/27/2017 11:43:53 am

Are you using a pen or vial? I use a vial and it's around $275 for 10 ml. A box of syringes is less than $20 and I use a syringe twice before discarding (more than that an they get dull). I just buy by syringes for cash rather than involve insurance.

Alan Bown

2/14/2017 01:10:34 am

I checked Lantus in Mexico 02/01/17 and it was $85 in Nogales. Not much of a savings considering Walmart @ $26.

I am currently taking Walmart short acting and Lantus. When my supply of it runs out I will be Walmart all the way.
I have discussed this with the Endro and have a go for the use.
I wish there was something to help with the weight gain.

Charles Ellis

3/8/2017 09:58:36 am

Hi Paticia, I just went on Medicare Feb 1st. When I was working I had Aetna insurance and paid $105 for Humalog 14 vials and $105.00 for Humulin N 11 vials for 3 months. When I retired I signed up for AARP MedicareRx Walgreens Prescription Plan. I just got my first 3 supply and and it cost $1002.00 for same quantities. I was devastated. I was looking on Medicare website and it says that if an endocrinologist recommends an insulin pump that Medicare would pay for it. It then seems to say that while they don't pay for insulin, that if you use a pump that they would then consider insulin as durable medical equipment and cover it. It seems that them 80% and then I would use my AARP supplemental plan for the 20% and I would pay nothing? Did you ever try to get Medicare to pay for insulin for your pump?

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Jadeczar

3/8/2017 06:32:17 pm

I currently have 100 prefilled lantus solostar insulin pens never opened always refrigerated not expired to donate to someone in need for a cost of $75.00 per box of 5 pens for shipping and handling.

Gerry

6/26/2017 04:50:02 am

Charles - I have been on Medicare for the last nine months. You are right, Medicare Part B covers 80% of the cost of the pump, pump supplies and insulin used in the pump. I think it is my Medigap plan that covers the remaining 20%. Medicare Part D covers insulin that ISN'T administered with an insulin ppump.

Insurance atenta doesnt pay anthing my deduckable is 6500 not met yet took out in 2016 ,please help with cost I cant take levimer allgeric

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Sandra

5/10/2016 09:06:08 pm

Very well thought out and excellently written. Thankfully I have very good health insurance and use a pump and CGM, but I always seek out info 'just in case' things go south. This article reminded me of when I was first diagnosed and was put on NPH and Regular 20 years ago. Just some other advice if I may add. If you low carb it (25 grams or less per day), you will need about 75% less basal within a few days, and this will save on your insulin requirements. Read up on the Keto diet for more info! Took my AC1 down from 9% to 5% ☺♥

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Randy

5/27/2016 05:25:31 am

Hi Sandra. Got a question. I've been type 2 for a relatively short time and i am trying to keep cost down. I'm on 1000 mg. Metformin (cheap) except for the $90 doctors appointment to write a $6 prescription! $90 for 3 minutes! And I do low Carb high fat diet. Facebook group(Type2diabetes straight talk) is a life saver! My mom took old school insulin and managed it herself. Wish she was around for advice now! Anyway... I upped my metformin to 1500 a day and have been eating less than 30 grams of carbs a day. My BS is still going up. I know waking up with a bs of 130. I know for most folks its not that extreme but i want to see it under 100. Is it reasonable to take just a small dose of NPH relion brand ? Never took it before. This article is fantastic! I just need an experienced second opinion from someone. I was really trying to keep from taking more drugs but...

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Alan Bown

2/14/2017 01:17:44 am

Limit on Metformin is 2100 mg a day I believe. I take 2000 a day. Glybride is generic and was used a lot for Big D unit someone decided that Dr's should not prescribe it. Glybride will cause your BS to lower, maybe farther than you should. AS WITH ALL ADVICE check with your endro before wandering off the path. I had to argue to keep it. My problem was never low BS always high. Also about every 16 months the program/diabetes changes and the meds adjust accordingly. Keep testing

Alan Bown

2/14/2017 01:12:00 am

Thanks for the tip on the diet. I need something to help with the weight gain.

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Michael

5/17/2016 09:44:32 am

What might help here? A bird's-eye-view of qualifications from groups/companies that assist with insulin. (Save lots of wasted time inquiring)

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Pat

1/9/2017 12:46:19 am

YES ... exactly. I know it sounds "lazy" BUT it consumes a lot of time (and energy/stress) trying to search out the websites and try to make sense of all of the different "rules" it takes to comply for each insulin needed.

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Nina Williams

3/23/2017 12:20:48 pm

I'm a 26 yr. type 1 diabetic. I'm on a pump, CGM, blood pressure pills, diabetic research meds and zoloft. I don't need as much Humalog but wanted to see if I'm wrong for wanting to sell the vials so I can pay utilities. Diabetes is a daily struggle.

Sarah

5/28/2016 03:44:17 pm

I was on NPH from 1976 to 2001...until everyone else in the diabetic community started giving me crap for being on an "archaic" insulin. Well, guess what. My A1c went from 6.0 on NPH to a 9.5 on Lantus and Novolog. About 8 on Lantus and Humalog. I've been a Type 1 for 40 years. Novolog was like injecting water...it did NOTHING for my numbers. It also "stacked" up on me, causing sudden lows after hours of highs. I also felt my lows coming with Humalog. Not Novolog!! I think the fancy insulins are garbage!! They require constant babysitting, which NPH did not. The worst part about NPH was that it did demand I eat when I sometimes didn't want to....and the dawn phenom was worse. But my number were excellent, I had more freedom to est carbs, and none of that crazy bolusing. I should have never switched. The pharmaceuticals know their insulins don't work. That was another thing...I needed much more Novolg than Humalog. NPH was 25 units per day, two shots, because it didn't last 24 hours for me. Novolog was 20 units per day to bat my highs down like a wack-a-mole (that never stayed down) and 25 units of Lantus...20 in a.m. and 5 in p.m. Of course the pharmaceuticals want you to plow through their insulins (that don't work) faster....so that you have to buy more at such an insane price. It's a scam! I Google this because if all the trouble and plan to go back to NPH.

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Kat

9/17/2016 06:31:52 am

I've just recently found myself in this scenario to be without insurance and now without my expensive novolog. I've been on an insulin pump for awhile now and now looking to change the convenience of it. I went the route of Walmart and purchased their Novolin R for $25. Just increased the basal a bit because I'm running a steady high for the last 12 hours. I'm already frustrated and physically feel like crap!!

Hi Kat, I'm so sorry to hear you're feeling like crap! Switching to a new insulin (especially going from analog to human insulin) can be a bit of an adjustment. Keep titrating your basal every 2 days or so until you get to a point where it works for you. If you'd like, you can join me for one of my next Baseline Challenge events. It'll help you figure out how to test and fix your basal rates - which may be especially helpful for you now that you're using a new insulin. You can sign up at the main page (bootcampforbetics.org)

Stephanie

11/14/2016 06:22:16 pm

The new insulins are not garbage. However, there is a small percentage of folks who do far better on the older insulins. My Dad was one of them. I am not, alas. Please don't disparage something that simply didn't work for you.

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Sheri

12/9/2016 10:38:45 am

I have been diabetic for over 40 years. I still take Humulin N and have bought it at Walmart when I had no insurance. I do use Humalog, but could go back to Regular if needed. The older insulins work fine for some of us.

Rita

12/7/2016 06:21:38 pm

I agree Lantus and Humalog didn't work at all . . . i starved myself and my bs couldn't be controlled. I stopped taking them and exercised and just took metaformin and the bs were the same as lantus and humalog. I am going to try NPH and see if that works and I sure hope it does. Thank you so much for your post.

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RITA ZANT

12/22/2016 08:26:30 am

You are absolutely correct . . .Lantus doesn't work very well and it is like injecting water. It was depressing and frustrating using it.

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tracey white

6/15/2016 04:01:13 am

i have read this and have to say it is very well written and very interesting.i cant believe how expensive everything is! i am quite new to this diabetes lifestyle, only diagnosed in february this year, and have been on humulin 30/70 ever since , with a fast acting insulin at lunch. i am soon to be changed over to levemir.
in the uk we have the nhs, and once you are classed as diabetic you are given free prescriptions for the rest of your life. i really wouldnt be able to afford this if i lived in america, and this article will surely save a lot of peoples lives! well done!

LillyCares.com has assistance for patients with these requirements:
To receive free Lilly drugs you must meet ALL of the requirements listed below:

I am a permanent, legal United States resident.*
My household income is under the Annual Income Limit.
I am NOT eligible for or enrolled in Medicaid or Veteran’s Administration Benefits. Humatrope patients may be eligible.
If I am a Medicare Part D patient (except Forteo patients), I have spent $1,100 on medicine this calendar year.
My doctor prescribed a Lilly drug available through Lilly Cares, and I have Medicare Part D OR no prescription insurance.

and the income limits are higher than most programs like Extra Help with Medicare Prescriptions, etc... Here is the income avail chart: http://lillycares.com/content/lillycares_table.aspx

It may help those who (like me) have fallen into the donut hole (and can't bolus for it! ha. ha. ha.) or are uninsured.

Thanks for the info. But it really does make me sad that one would even have to write an article on this topic. Drug companies are so wealthy, they could provide these needed drugs to low income people for free and still be okay.

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Patrick J Parsons

7/29/2016 07:18:25 pm

It is unimaginable that the "donut hole" even exists. It is only designed to punish all the old people that have retired and are no supposedly living of the public dole. Like the rest of you, I spent 25 years investing in my retirement and it isn't now and never was part of the part of the public dole.

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Althea

11/21/2016 03:27:04 pm

You can thank the Senate and Congress for voting for this.

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Mike Ansley

7/29/2016 11:12:29 pm

Fantastic article. I have type 2 and have been taking metformin 2500mg daily and 160mg of glilazide daily, and victoza 1.8mg daily. I was started on lantus about a week ago. started at 5u at dinner time, and have been increasing it by 2-3u every 2-3 days and have to keep doing this untill my fasting test is at 7mmol/l. yes I am Canadian eh. I live in norther Alberta in a town of 3500 ppl. plus surrounding communities with about 3 full time doctors, 1 part time, and a couple of docs that drive up from Edmonton every now and then. It does take some time to get a chance to see a doctor. I would like to start taking a regular insulin durring the day to help with getting my day time numbers down. So if this was you what Circumstance number would you try. I would take any advice not as a medical have to do but as an educational thing. I want to use regular because if doc does note prescribe it the my health insurance will not pay for it.

Since I'm not a doctor, I can't give you official medical advice, but I can tell you what I would do if I were in your situation. First, I'd take a look at all the meds I was taking. Glipizide is a sulfonylurea, which triggers your pancreas to produce more insulin (so now that you are taking insulin via injection, you're getting extra insulin thanks to the Glipizide AND the injectable insulin). The Victoza does a few things, actually, and one of those things is to cause your food to digest more slowly, which can sometimes cause low blood sugar problems if you’re taking mealtime insulin (like regular, humalog or novolog). Victoza also suppresses the amount of glucose that gets pushed into your blood by your liver, which, incidentally, is what Metformin does. Lastly, Victoza also causes your pancreas to produce extra insulin when your bg is high. So basically, with the drug cocktail you're on, you're doubling up on the liver suppression meds (Metformin, Victoza) and you're tripling up on the extra insulin (Injectable, Glip and Victoza). Any medications that help keep your blood sugar closer to target range are going to be helpful for your blood sugar. However. If you are interested in taking an intensive management approach (this is a big life change), you could talk to your doctor about ditching the Victoza and Glip and instead take only Metformin and injectable insulin. I like my medication regimen to be clean without redundancies, and you’ve got a lot of redundancy with your med regimen, which is actually very common, because doctors tend to just pile new meds on top of the old ones until you’re taking forty pills a day.

So, I haven’t answered your question yet. I’ll do that now.

If I were in your situation, I’d do some experiments with the regular insulin to see what happens. But I’d be a little nervous about doing so, because the Glip and the Victoza are also causing insulin to shoot into my blood.

Many folks on insulin use a calculation called a “carb ratio,” which basically says that for every X grams of carbohydrate I eat, I get Z amount of insulin.

For example, my carb ratio is 10. This means that when I eat 10 grams of carbs, I take 1 unit of insulin. When I eat 60 grams of carbs, I take 6 units of insulin. Everyone’s carb ratio is different, and it’s hard to know where to start. If I were you, I’d start very conservatively. Try taking one unit of regular for every 50 grams of carbs you eat. Check your bg every hour for 7 hours (if you were on Humalog you’d only have to check for 5 hours) afterward to see what happens. If the insulin doesn’t help, try the experiment again tomorrow, taking one unit for every 40 grams of carbs you eat. Repeat until you come up with a good “carb ratio.”

Also, for high blood sugars, you can use Regular insulin to lower your blood sugar. Check out my article from last month about that:

A long time ago a Dr at our ER gave me a ratio list and it goes like this (NOT FOR CHILDREN!!! They process insulin differently):
200-250=5u
250-300=7u
300-350=10u
350-400=12u
400-450=15u
450-500=17u

Peggy Churchill

7/30/2016 11:26:27 am

This is the most valuable information I have ever found. It took MD's forvever to diagnose me even though my eye Dr. had been saying I was diabetic from the age of 7-8. Not enough room to tell about all the misinformation I've had from GP's. Specialist tried all the popular brands of insulin but they didn't help me much. One experimental brand ,Symlin, worked great for a year, then I became resistant to it. A new insuance company at work would pay more for Novolin, (generic), brand but I had to purchase it through a specific pharmacy. Novolin R&N combined with Metformin controls my glucose the best and the Metformin did wonders for my vision. Now I'm forced to switch to medicare, (the insurance for life after 40 years at work was another lie). Medicare doesn't pay much towards insulin and I've been checking for the best prices for Novolin using self pay. I've found everything is just as you've said. But this is the first place I've found all the formulas and information. Doctors and pharamacist won't give it out.

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J. Woolverton

8/26/2016 02:54:03 pm

Tyler, Texas here. Thank you soooooo much for this info. My mom runs out of her Novalog and now uses the Regular R to fill in. I just gave this link to my cousin who was just as thrilled to have the info.

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Wayne Nelson

10/26/2016 04:50:36 am

I use lantus,novolog .because of price started nph30/70 . I have better control. I can eat and not have glucose jump high. Dr. Dosen't think it works.

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Al

11/8/2016 12:41:02 am

Thanks for this life saving info. My doctor is insistent that I use Tresiba, Toujeo or Lantus. I know this is by far a superior insulin, but I can not afford the $300 copay, on top of the copay for all the other oral drugs I take. I am spending upwards of $750 just in copays and co-insurance. I wish my employer would offer better insurance but they don't and that disqualifies me from getting any assistance in the marketplace. I'm between a rock and hard place, so knowing how I can switch to regular insulin will definitely help.
One question. If I use Lantus or Levemir part of the time and this old school insulin in between, would that cause any issues that anyone know of?

Al - Excellent question. Here's my (non-medical) advice about this. If I was going to jump from Lantus/Levemir to NPH, I'd start the NPH roughly 24 hours after my last Lantus/Levemir shot. If I was going to jump from NPH back to Lantus/Levemir, I'd start the Lantus/Levemir roughly 12 hours after my last NPH shot. Basically, when you switch long acting insulins, you want to start with a "clean slate." If your blood sugar goes high during the "slate cleaning," supplement with short acting or, preferably, rapid acting insulin.

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chuck

1/3/2017 05:41:19 pm

I am going on insulin after being d iagnosed at age 61 with type 2. My buddy has been buying the Mexican Lantus and it works fine for him at less than half the cost. I wish I could get my new insurance to pay for it, but they won`t. I am going to have to go visit my friend and stock up. If you live close to Mexico, check it out.

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Jane M.

12/29/2016 10:43:56 am

Just starting to plan for retirement in 2017. The insulin coverage, lack of it, is shocking to me. I am a juvenile diabetic kept alive for 38 years on insulin and have been enjoying my pump which almost makes me feel normal. Thank you for this site and the information. I see my planning is a little more intensive now.

I run a non profit pharmacy here in Memphis, TN. We would switch all of our members(mostly uninsured or on Part D) that came to us on the expensive brand name insulin's to one of the Novolins. Because of Wal Mart exclusivity deal with the manufacturer, they are the only ones that can sell it at $25/vial. I would personally go to the nearest wal mart before work or during lunch to get as many vials I could. Then, charge my members what we paid for it.(NOTE: If someone was only on insulin, we sent them straight to Wal Mart because there was no need to pay monthly membership) It worked just as well for every single one of them. Due to the press we have received recently, Wal Mart has cut us off from buying their insulin. With the exclusivity deal they have, we have to swallow our pride and send our members to wal mart in order to stay true to our mission of making sure people always obtain their medications.

I am not sure how US diabetics can organize and sign petitions for congress and pharmaceutical companies. The US is one of the only countries with a form of socialized medical theft does not regulate drug prices. Congress even paced a law to make it a crime to mail order your drugs from another country. In reality this is a profit grab by the pharmaceutical companies supported by politicians who have been lobbied by the pharmaceutical companies. Perhaps you can help by having a web site to help facilitate the petition drive .

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Sheri

1/9/2017 06:38:32 am

If the government does not reign in personal injury lawsuits against pharmaceutical companies, there will be no cost decreases. The USA is one of the only countries you can win millions for a side effect CLEARLY listed on the box. Until people are made responsible for their own choices and stop using the courts as a lottery system, prices will not come down. Drug companies build in millions of dollars for settlements with every drug.

Also, the US may not actually want MORE socialized medicine. Maybe we want LESS. Obamacare, medicare and medicaid are all cost-controlled and going broke. Doctors won't accept patients. Limiting profits means limiting research and advancements. Don't assume everyone thinks they are entitled to free medical care or subsidized medical care.

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Sheri

1/9/2017 06:42:37 am

The US can also dispense with the TV advertising of drugs. It encourages people to make decisions based on slick advertising, not actual need or science. Plus, it adds million to the cost of drugs.

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April

1/18/2017 01:56:54 pm

Reading these comments makes me sad, I have been a diabetic for 8 years now and have always had medicade to help me with doctors visits and help paying for my isluin. I was cut from medicade back in November 2016 because of a $1.00 raise at my job. My doctor won't see me because it's $145 out of pocket to be seen and I can't afford $530 for a bottle of lantus. I have called wall mart and they told me about the $25 bottle they carry and I can use that to replace my lantus. My only concern is if I'm taking 60 units of lantus should I take the N and take 14 units twice a day? I'm lost with this switching over and don't know what to do.

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Sheri

1/19/2017 11:04:09 am

I take NPH. I tried Lantus, but was VERY allergic to it. When I was in the hospital in 2015, they tried splitting my nph dose to 1/2 in the AM and 1/2 in the evening. It worked for a while, but I ended up going back to most of it in the morning and less in the evening (I take mine at bedtime). My dosages are not "typical".

NPH has a very definite peak—you'll need to test more often to know what the effect will be. It's not nearly as flat a profile as Lantus. I use the Walmart "Prime" meter to check blood sugars often and it's fairly accurate. You need to check at least once or twice in the afternoon to be sure you're not getting low. That way you'll know when the insulin peaks and can eat something to prevent lows. That was the recommendation when I was much younger—to eat an afternoon snack around 3 or 4. It may or may not be necessary depending on the person.

I usually take Humalog at mealtimes. I am guessing you don't because you didn't mention any insulin other than Lantus. Once on a trip to a medical appointment in another state, I ran out of the Humalog and insurance said it was too early to buy more. I wasn't going to pay $250 for insulin I had at home, so for 2 days, I split the doses of NPH, cut carbs and tested often. It worked fairly well.

If you're type 2, the biggest change will be the afternoon peak. I found that splitting the dose to 1/2 AM and 1/2 PM make the peaks less noticeable. The PM dose can cause you to be low during the night, so check often. Once you do this for a few days, the pattern will become evident.

It's scary to switch, I think, because all of medicine assumes you can buy whatever the doctor finds works, irregardless of cost. I notice all the commercials say "don't change your dose without consulting your doctor". Type 1's often self-manage so it can certainly be done. Also, things change. When my insurance wouldn't pay for the brand I have always used, I asked my doctor about switching brands. For decades, I was told never to do that. My doctor said it was no big deal now. Why that changed, I have no idea. (I didn't switch—I stretched the insulin I had till I could get the brand I wanted. The idea still makes me nervous, but if I were to lose insurance, I'd use the Walmart generic. It's not like I have a choice at that point.)

I found this link on dosing:
http://reference.medscape.com/drug/humulin-n-novolin-n-insulin-nph-999006
It might help. My split doses while in the hospital were calculated by the formula in the article.

I've been doing this nearly 45 years. It can be handled. Just go slow and test frequently at first. You can do it.

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Sheri

1/27/2017 11:47:00 am

This isn't exactly about insulin costs, but I am now switching from AcuCheck for my meter to Bayer. They have a very low-cost meter and strips. This in addition to using the Reli-On. Even with insurance, the cost of many strips are very, very high and with some research, you can find meters that work well and don't cost as much. There are many ways to deal with the costs of being diabetic.

You can get the testing strips for the Bayer Ascenia from Amazon sometimes for $26 for 100 strips. That is the only place I buy them. I was also able to get a meter for $4 as an add-on.

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Alan Bown

2/17/2017 11:16:58 am

I tried that but returned the strips. Due to the slow postage and the MFG stating that the strips should never be over 80.
Postage in the desert SW and 80F is pretty much winter time for us. If the company is not keeping them cool then your approaching garbage in, garbage out. Wally world is just tad more expensive.

Sheri

2/17/2017 02:42:08 pm

My Bayer Contour Next strips say STORE between 41° and 86° F. The range for the meter is 41° to 113° F. I can attest to meters not working well at even 41°—I often have to warm mine up when it's that cold.

As was pointed out to me when I complained about getting frozen by mail order, one has no idea if the insulin or strips were shipped or stored under proper conditions even when buying at the pharmacy. It is an assumption that Walmart or whomever, properly stored and transported the strips and other supplies.

It is interesting that people worry so much about heat hurting things, but freezing is far worse. The insulin can be spoiled by freezing and the meter just won't work till it warms up. Insulin manufacturers don't seem terribly concerned about these things, nor do strip manufacturers.

There was one advantage to the pork and beef insulins—they did not require refrigeration. We kept them in our bunks at camp when the temperature was 102° F for a week.

I order strips from Walmart for Reli-on since they are the only source and Amazon for Bayer, since they do have good deals. I'm not worried about the strips, but if one is, it's fine to purchase in person. (I refuse to go to Walmart in person, so I order.)

Barbara Cox

2/6/2017 09:56:36 am

I have used u-500 in my pump for over 5 years. My a1c is 7.3. I retired, and am on Medicare advantage for prescription drugs. Found out the cost would be over $1500 a vial, I need 1.5 a month. My cost would be $366 a month, and my $3700 yearly medication allowance would be used in 2 months. Dr switched me to humalog, which is cheaper, and is working, but, $990 a month is deducted from my $3700 allowance. My income from social security, pension, and part time job exceeds the max allowed for assistance from anyone. I am seeing my Dr tomorrow regarding my option of going on the NPH insulin at Walmart. I am very frustrated at this point.

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James

2/28/2017 01:33:30 pm

Hi, I am also a type 1 diabetic from the UK, if you email me I may be able to help you, its Durhamboys@gmail.com.

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Nina Williams

3/23/2017 12:30:39 pm

email me if you still need Humalog...wninae@msn.com

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Mary Walsh

2/28/2017 05:59:34 pm

I'm trying to find info for my friend Carole...she recently has to start all rhe diabetic meds. She's a widow and 67.She needs help getting meds. Last night she told me that she's so depressed she's not sure she wants to wake up. I can't get all of your info..she has a cheap phone....Her health ins.doesn't cover her meds.Is there a phone number I can give her?I don't understand alot of this, but if you could write or talk to her...maybe she would feel better.

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Sheri

3/1/2017 11:13:41 am

Have her contact the manufacturer of the drugs. Many will help cut the costs, especially if it's a newer medication. (Older ones generally are not discounted.)

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James

3/1/2017 11:16:52 am

Im unsure if her meds will be the same as mine, but if you tell her to email me I will try to help.

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Mike

3/4/2017 11:51:54 pm

Diagnosed Type 1 3 years ago after wasting away from 212 lbs. to under 130 in half a year's time. Had insurance through the county at the time as I didn't have the energy to work any longer. My co-pays for lantus and novolog pens were $3 each. Flash forward a year and my health, weight, and bs numbers are much better, allowing me to again be gainfully employeed, and insured as well. My co-pays now for lantus and Humalog (prescription plan wouldn't cover novolog, and on a side note, humolog seems to me to take significantly longer to work, but, I digress) are now $150 per prescription. This has already caused me to ration doses at times. Knowing the information provided above is a huge relief, as I'm feeling time for new employment, but have been terrified of risking going without coverage and subsequently wasting away yet again. I don't doubt the product may not be quite as good, but here in the real world we have to use practical application of policy, and being gouged for a thing we literally need just to KEEP FROM DYING is not practical for me, and I suspect the vast majority of us as well.

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Sheri

3/5/2017 11:07:29 am

I just want to note that the products may or may not be quite as good. I have used the NPH Humulin for 45 years (originally, it was beef/pork insulin). I tried Lantus once—severely allergic. While dealing with the peaks of NPH takes some getting used to, I can't say that NPH is not as good an insulin. It may or may not work well for you. You won't know until you try it, if you end up having the need to change.

Humalog varies in the time it takes to kick in—some people have to eat before taking it to avoid lows. Some people, myself included, often take 15 to 30 minutes or longer for it to kick in.

(Dramatic way to find out you're diabetic. Did you end up in a coma or did they figure out what the deal was before that? I was diagnosed as "anorexic", not diabetic, and ended up in a coma.)

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Mike

3/5/2017 09:34:46 pm

Thankfully no coma, just a drastic increase in amount of naps. Funny part is, when I went to get checked, it was for prostate due to the massive increased frequency of urination (being an early middle aged male, that was my suspicion.)
Clinician, having never seen me before, had me diagnosed in less than 10 minutes. An hour later I was hospitialized. Don't even know what exactly my b sugar was, just "off the scale."

Not saying I'm going to ditch my prescriptions and run to Wal Mart right away, just highly relieved to know The option is there should the need arise, particularly in the current political climate where I don't see health care costs being reigned in anytime soon.

Sheri

3/6/2017 07:07:06 am

I understand. Glad you didn't end up in coma. I have looked at cost options over and over again as my husband changes jobs (he works in energy most of the time—boom and bust) in case I can't get coverage. Now, I have to go with Cobra no matter what the cost due to other health risks. Still, deductibles are outrageously high so I might still have to buy insulin during that time. Until 15 years ago or so, I used to just buy the NPH (Humulin N) because it was so cheap. I used Walmart when Lilly made it, but not now. It's always good to know your options, even if you never have to exercise them!

A

3/25/2017 04:47:28 pm

I'm sold on Novolin NPH. The state is being slow about determining which insurance we qualify for because my son was laid off from his job and now the household income doesn't match what the irs reports. After much stress and feelings of hopelessness because I worried my son would die from dka, I found this very helpful post. I didn't know Novolin could be purchased without a prescription. What a life saver! My son took his first injection last night. I multiplied by .85 and divide by two like suggested and arrived at 21 units. He actually ran high but didn't take more at 4:30 am like he was supposed to. I upped it to 25 at 9:30 am, which is exactly half his Lantus dose. It's 8 hours later and he's stable at 70. This is with a Humalog correction at 9:30 am and he hasn't eaten all day. He is perfectly stable with no peaks on this allegedly inferior insulin. This is a huge weight off my shoulders. I no longer have to worry about the AHCA or what Trump does to it. Thank you!

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John Molloy

4/8/2017 04:01:19 pm

My wife just got diagnosed for Diabetes and although we are covered with Medicare and supplemental insurance for the 20% we dropped the ball getting part D coverage. So far I'm looking at Blink Health for prices. Your web site is most appreciated. Regards, J. Molloy for Wife Gracia.

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Nae Wright

5/13/2017 03:24:33 pm

TY so much this was VERY helpful. God bless.❤

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Linda

6/2/2017 10:23:26 am

I was doing pretty good with my Novolog/Lantus routine. Was dieting, trying to keep carbs to 100-120/day, lost about 15 pounds so far and my last A1C on Nov/Lantus was 8.1 which is good for me - for now. Well, I joyfully retired and faced Medicare - which sucks for insulin users. Can't afford it - so I've changed w/Dr. approval to WalMart R and N. 60 u of Lantus converted to approx. 25 am and pm. I have since increased it to 30 x 2. My sugars are not doing well. Morning levels used to be between 100-150. Now I cannot seem to get out of the 200 levels, more closer to 250's. I don't know what to do, should I increase the NPH? I take approx. 10-15 u's of R with each meal depending on b.s. level. Any advice??? My Dr. is very young, I like her, but she knows even less about this insulin than I do, searching for an Endo, but they cost me mega bucks for a visit.

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Sheri

6/3/2017 06:05:39 pm

Linda Onash: (I can't respond on the Facebook comments) I am speaking only from person experience and it may not apply for you, but I take NPH and Humalog. NPH has a peak and can cause lows overnight which result in high blood sugars AM. It's called the Somogyi effect. There's also the Dawn Phenomena, which makes blood sugar rise early in the morning. Lantus is "flat" in its action, no highs or low like NPH.

My morning blood sugars run around 250 to 350 much of the time, with or without overnight NPH. No one has had much luck fixing it ever. Currently, I take 20 NPH in the morning and no more until the next morning—nothing overnight. I don't split the dose as you are doing. I only take 1-3 units at bedtime when I do take it. I know the modern theory is split dose, but that failed for me. It apparently works well for others.

Since you are splitting a dose of NPH as 30/2, adjustments are trickier and you probably need your doctor to help. It will help if you can test once or twice during the night so the doctor has an idea of whether or not you're gettting high or low and when. It's a pain, but it's the only way to know what that PM dose is doing to you overnight.

I hope your doctor can help you figure this out. You may not reach the stable blood sugars you had on Lantus. One does the best they can under their circumstances.

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Chris Morgan

6/15/2017 11:13:04 am

If your problem is seeing a doctor or maintaining prescription coverage, there are online options. You can buy prescription insulin online, through Canada, without a prescription. Many other pharmaceuticals too, like antibiotics or male enhancements. Keep in mind that shipping can take weeks, and prices are not much lower than local pharmacy. But if you can't get to the doctor, this is an option. Search on google or yahoo for "buy 'whatever medication' without" and you will see many valid links. Compare prices to get the best deal.

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martha

8/15/2017 12:57:31 pm

There also is a "gray" market for insulin. Check Craigslist. You can sometimes get a bottle of Lantus for $25. Some risks, but have had good luck. You do what you have to do.

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Author

Hi, I’m Kara. I’ve been type 1 diabetic since 1986. I’ve been attending diabetes camp since 1987. I’ve been a camper, a counselor, a staff director and training director at diabetes camps for the last 30 years. I have a regular day job as a technology consultant, and even though I like my day job, diabetes is my true passion. My late maternal grandmother had diabetes, and died from complications related thereto. Both of my grandfathers have diabetes, and so do my dad and my uncle. My little brother is hyperinsulinemic, which means that his pancreas is already overproducing insulin to counteract his body's insulin resistance. I hate diabetes! But guess what. Diabetics aren't doomed. There is a way to have diabetes and still live a long and healthful life, but, at times, it can be hard as hell. Like, really, really, insanely hard. But I’ve finally figured out how to lower my blood sugars and keep my A1C at a reasonable level. And it's not easy, and sometimes I screw up, but my method is totally workable for anyone who wants to fix their blood sugar, including you. And I want to share what I’ve learned with you, so that you can be healthy and feel better, too.